The Use of Tweet-Format Narrative Reflections During a Service-Learning Trip to Appalachia


  • Tracy P. George Francis Marion University
  • Allison C. Munn Francis Marion University
  • Tiffany A Phillips Francis Marion University
  • J. Marty Hucks Francis Marion University



Background: Tweet-format narratives have been used in medical education to capture student experiences. However, there is a lack of research on tweet-format narratives during experiential learning in nursing education.

Purpose: The purpose of this project was to explore the usefulness of tweet-format narratives to capture nursing student experiences and to elicit reflection during a service-learning trip.

Methods: Eight bachelor of science in nursing (BSN) students participated in a service-learning experience to Appalachia. A grounded theory approach with three data collection methods was used to determine the usefulness of tweet-format narratives to facilitate student reflection during the event. A free closed text-messaging app was used to house tweet-format narratives. A focus group session and post-survey were conducted at the conclusion of the trip. Emergent themes from each data collection method were compared and modified using iterative techniques and constant comparison analysis until the data were saturated.

Results: Focus group responses were reflective in nature and included student elaboration about content themes that were previously identified by the tweet-based narratives. Modification of themes resulted in six final themes of improved skills, cultural competence, patient interaction, socioeconomic factors and health, landscape/clinic setting, and impactful shared experiences.

Conclusions: It is important for nursing students to reflect on their experiences during service-learning immersion trips, especially as they relate to underserved rural populations and their unique healthcare scenarios. With the growth of social media, more nursing students are accustomed to communicating in a short, text-based format. The tweet-format narratives in the free closed text-messaging app allowed students to reflect on their experiences through open-ended comments and to communicate with other members of the group. Short text-based narratives can be an effective narrative medicine technique for nursing students participating in service-learning trips in rural areas.

Key words:  narrative medicine, rural health, service-learning, technology


Author Biographies

Tracy P. George, Francis Marion University


Assistant Professor of Nursing and Coordinator of the Bachelor of General Studies Program

School of Health Sciences

Allison C. Munn, Francis Marion University


Assistant Professor of Nursing, School of Health Sciences

Tiffany A Phillips, Francis Marion University


Assistant Professor of Nursing

School of Health Sciences

J. Marty Hucks, Francis Marion University


Assistant Professor of Nursing

School of Health Sciences